Conclusions:

In conclusion, cTnI levels, detectable with a novel hs assay, identify patients with PH who have more severe hemodynamic and cardiac structural abnormalities and provide novel and independent prognostic information. This hs assay has the potential to detect more at-risk patients and improve current risk-stratification algorithms.

Perspective:

The novel hs cTnI assay has an approximate 10-fold lower detection limit compared with recent generation assays. cTnI was detected in two-thirds of the cohort who would have been undetected with standard assays. Nearly 70% of subjects had pre-capillary pulmonary arterial hypertension (PAH), in whom cTnI had prognostic ability even after adjusting for known markers of more advanced disease. Further studies are needed in the varying causes of PAH, as well as PH associated with left heart and valvular disease, lung diseases, and pulmonary embolism.